Please try to give as much detail as possible

Please share any challenges, sensitivities, or changes you’ve noticed in the following areas.  Feel free to elaborate as much or as little as you wish. Note anything else about your senses or physical appearance that feels relevant to your wellbeing.

Please describe here any relevant family medical history, diseases and hereditary conditions. 

By choosing to participate in a naturopathic consultation with Shanti Smith of Thrive Therapies, you acknowledge that our holistic approach is designed to support your body’s natural healing with recommendations such as nutrition, lifestyle changes, and herbal remedies. Your involvement is entirely your choice—you are encouraged to accept, modify, or decline any recommendations, and participate in your care as much or as little as feels right for you. You confirm that you have disclosed all relevant medical history, current medications, and treatments.

Naturopathic care does not replace medical diagnosis or emergency treatment. Please consult your medical doctor as you see fit. Your wellbeing, comfort, and autonomy are our top priorities, and you are warmly encouraged to ask questions at any stage of your journey.

By signing below, I confirm I have read and understood this consent.  I release Shanti Smith of Thrive Therapies  and the facility from liability relating to this and future treatments or recommendations. I understand that Thrive Therapies and Shanti Smith are not responsible for outcomes related to any treatments, suggestions, recommendations, or herbal formulas, now or in the future.  All information I share will be kept confidential.

I consent to Thrive Therapies using AI tools for these purposes—assisting with communication and administrative tasks related to my intake forms and email/messages, including analysing, organising, and summarising my provided information to help prepare clearer written responses and correspondence. I understand this support is intended to improve efficiency and clarity, and is a helpful assistant and not a replacement for Shanti Smith’s care, professional knowledge, or the Thrive Therapies services I receive, and any information shared is confidential and used only to support my care and wellness journey at Thrive Therapies. If you have any concerns or questions, please let Shanti know.